The present embodiments relate to detecting a regurgitant orifice. In particular, the regurgitant orifice is detected from medical scan data. The present embodiments also relate to refining the detection of valve anatomy according to the detected regurgitant orifice.
Valvular heart diseases are a major cause of death in developed countries. In 2006 in the United States, valvular heart diseases are estimated to affect 2.5% of the population and are the underlying cause of over 43,700 deaths and 93,000 hospital discharges. Pooled data from multiple studies suggest that the prevalence increases with age from 0.7% in participants 18-44 years of age to 13.3% in participants >=75 years of age.
Stenosis and regurgitation impair transvalvular blood flow and reduced cardiac function. Specifically, stenoses reduce the transvalvular flow through a narrowing of the heart valve as opposed to regurgitation, where the valve is rendered incompetent by insufficient closure. This insufficient closure allows for pathologic reverse flow. Treatments include medication, or repair or replacement via open-heart surgery or implants delivered via catheters or minimally invasive instruments.
Valve competency is routinely assessed using quantitative and qualitative information both from anatomy and blood flow shown in four-dimensional (3D+time) B-Mode and Color Doppler obtained using transthoracic (TTE) and transesophageal (TEE) echocardiography. Four-dimensional imaging enables more accurate non-invasive assessment as compared to two-dimensional echocardiography. Four-dimensional imaging allows quantification with anatomical dimensions and hemodynamic biomarkers, such as proximal isosurface velocity area (PISA) and effective regurgitant orifice area (EROA). While these biomarkers are widely accepted, the quantities are derived manually. The amount of information to be processed manually is large with four-dimensional imaging. Due to manual calculation, inter- and intra-observer variation results.
Moreover, 3D B-Mode imaging is not able to capture regurgitant orifice area. Hence, color Doppler imaging is used to find the location of regurgitant jets. Rendering both 3D B-Mode and color Doppler flow images together still may not show the regurgitant orifice since the color overlay often obscures the view onto the valve.